title: Functional neuroanatomy of disorders of consciousness.
abstract: Our understanding of the mechanisms of loss and recovery of consciousness, following severe brain injury or during anesthesia, is changing rapidly. Recent neuroimaging studies have shown that patients with chronic disorders of consciousness and subjects undergoing general anesthesia present a complex dysfunctionality in the architecture of brain connectivity. At present, the global hallmark of impaired consciousness appears to be a multifaceted dysfunctional connectivity pattern with both within-network loss of connectivity in a widespread frontoparietal network and between-network hyperconnectivity involving other regions such as the insula and ventral tegmental area. Despite ongoing efforts, the mechanisms underlying the emergence of consciousness after severe brain injury are not thoroughly understood. Important questions remain unanswered: What triggers the connectivity impairment leading to disorders of consciousness? Why do some patients recover from coma, while others with apparently similar brain injuries do not? Understanding these mechanisms could lead to a better comprehension of brain function and, hopefully, lead to new therapeutic strategies in this challenging patient population.
authors.affiliation: Coma Science Group, Cyclotron Research Centre & Neurology Department, University and University Hospital of Liege, Liege, Belgium; Department of Neuroradiology, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: Carol
authors.initials: C
authors.lastname: Di Perri
authors.forename: Johan
authors.initials: J
authors.lastname: Stender
authors.forename: Steven
authors.initials: S
authors.lastname: Laureys
authors.forename: Olivia
authors.initials: O
authors.lastname: Gosseries
mesh_terms: D001364:Awareness; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D003244:Consciousness Disorders / Q000175:diagnosis*; D006801:Humans; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D009445:Neuroanatomy; D059906:Neuroimaging
keywords: Brain connectivity; Coma; Consciousness; DOC; EEG; General anesthesia; MCS; Minimally conscious state; Neuroimaging techniques; TMS; UWS; VS; Vegetative/unresponsive wakefulness syndrome; disorders of consciousness; electroencephalography; fMRI; functional magnetic resonance imaging; minimally conscious state; transcranial magnetic stimulation; unresponsive wakefulness syndrome; vegetative state